ArticleCHEST critical care2023
Trajectories of Host-Response Subphenotypes in Patients With COVID-19 Across the Spectrum of Respiratory Support.
Article in CHEST critical care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Characterization and 3-Year Survival of Clinical Subtypes and Host Response Phenotypes of Acute Respiratory Failure Requiring Mechanical Ventilation.CHEST critical care · 2026Article
- Dynamic Cytokine and Coagulation Profiling in Patients With Severe COVID‑19 Evaluated for Pulmonary Embolism: A Prospective Cohort Study.Medical science monitor : international medical journal of experimental and clinical research · 2026Observational
- Novel Phenotypes of Acute Respiratory Failure and Differential Response to Awake Prone Positioning: A Multi-Cohort Study.MedComm · 2026Article
- The bug, the burden, and the biology: beyond host-centric phenotyping in sepsis.The Journal of clinical investigation · 2026Article
- Microbial lung-to-blood translocation associates with systemic inflammation in severe pneumonia: evidence from paired plasma and lower respiratory tract metagenomics.Intensive care medicine experimental · 2026Article
- Plasma Levels of Soluble ST2 Reflect Extrapulmonary Organ Dysfunction and Predict Outcomes in Acute Respiratory Failure.Critical care medicine · 2025Observational
- Clinician Prediction of Hyperinflammatory Acute Respiratory Distress Syndrome Subphenotypes: Overestimated but Prognostic.American journal of respiratory and critical care medicine · 2025Article
- Dynamics of Subphenotypes in Critical Illness: When the Tick-Tock of the Clock Counts.American journal of respiratory and critical care medicine · 2025Article
- Temporal Transitions of the Hyperinflammatory and Hypoinflammatory Phenotypes in Critical Illness.American journal of respiratory and critical care medicine · 2025Observational
- Clinical and biologic profiles of patients with acute respiratory distress syndrome by prevalence of chronic obstructive pulmonary disease or emphysema; a cohort study.Respiratory research · 2024Article
- Neutrophils and galectin-3 defend mice from lethal bacterial infection and humans from acute respiratory failure.Nature communications · 2024Article
- Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort.Critical care (London, England) · 2024Observational
- Glucocorticoid use in acute respiratory failure from pulmonary causes and association with early changes in the systemic host immune response.Intensive care medicine experimental · 2024Article
- The utility of procalcitonin for identifying secondary infections in patients with influenza or COVID-19 receiving extracorporeal membrane oxygenation.Therapeutic advances in infectious diseaseArticle
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30 authors.
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Abstract
backgroundHospitalized patients with severe COVID-19 follow heterogeneous clinical trajectories, requiring different levels of respiratory support and experiencing diverse clinical outcomes. Differences in host immune responses to SARS-CoV-2 infection may account for the heterogeneous clinical course, but we have limited data on the dynamic evolution of systemic biomarkers and related subphenotypes. Improved understanding of the dynamic transitions of host subphenotypes in COVID-19 may allow for improved patient selection for targeted therapies. RESEARCH QUESTION: We examined the trajectories of host-response profiles in severe COVID-19 and evaluated their prognostic impact on clinical outcomes. STUDY DESIGN AND
methodsIn this prospective observational study, we enrolled 323 inpatients with COVID-19 receiving different levels of baseline respiratory support: (1) low-flow oxygen (37%), (2) noninvasive ventilation (NIV) or high-flow oxygen (HFO; 29%), (3) invasive mechanical ventilation (27%), and (4) extracorporeal membrane oxygenation (7%). We collected plasma samples on enrollment and at days 5 and 10 to measure host-response biomarkers. We classified patients by inflammatory subphenotypes using two validated predictive models. We examined clinical, biomarker, and subphenotype trajectories and outcomes during hospitalization.
resultsIL-6, procalcitonin, and angiopoietin 2 persistently were elevated in patients receiving higher levels of respiratory support, whereas soluble receptor of advanced glycation end products (sRAGE) levels displayed the inverse pattern. Patients receiving NIV or HFO at baseline showed the most dynamic clinical trajectory, with 24% eventually requiring intubation and exhibiting worse 60-day mortality than patients receiving invasive mechanical ventilation at baseline (67% vs 35%;
interpretationLongitudinal study of the systemic host response in COVID-19 revealed substantial and predictive interindividual variability influenced by baseline levels of respiratory support.
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